Description: Virtual - Session 8B: The Future of Transplantation and Risk Management

Description: Virtual - Session 7A: What Happens When ACOs Get SAHS-sy?

Description: Virtual - Session 8C: Climate Change - Are We at Risk Yet?

Description: The health insurance industry has historically used several factors to develop premium rates. Many of these, e.g. gender rating, have been largely eliminated from health insurance rating practices by regulations as the Patient Protection and Affordable Care Act (ACA) because they were determined as inequitable. However, several other factors still remain as differentiators in premium rates charged to individuals and groups. In conjunction with the SOA, researchers studied whether there could be ‘ghost’ rating factors, like race, ethnicity, or socioeconomic status, that are inherently included in some of these remaining allowable factors. Review results and opportunities for future research. By attending this webcast, you will be challenged to think about traditional rating factors in a different way. Rather than focusing on whether certain factors are sound based on the underlying claims cost, this session will focus on whether or not these factors are impacting certain socioeconomic or racial/ethnic groups disparately.

Description: "Can you answer the question 'what are the chances we will lose more than $1 million next year?' without saying 'it depends'? If you miss a projection, can you quantify the chances that the miss was due to random variation vs. an incorrect projection? ten in as presenters demonstrate how to answer these questions and others using total risk analysis. Total risk analysis includes quantifying both the random variation risk and the projection risk associated with actuarial functions like pricing and reserving. After attending this session, you will be able to describe total risk analysis, apply total risk analysis to many actuarial functions."

Description: "Examine the impact of traditional deductibles on health care equity and the need for innovative plan designs. You will learn about the limitations of consumer-driven health care costs broadly today, as well as alternative cost-sharing approaches that have been successful in driving consumerism without exposing members to high costs. By attending the session, you will be able to: Have a clearer understanding of the issues surrounding deductibles Be equipped with practical ideas for creating more equitable and effective cost-sharing solutions Assess the feasibility and potential impact of implementing these solutions for your own organization"

Description: Health is wealth, but much needed medical insurance for various needs is perceived solely for the wealthy and elusive to many. This webcast brings two highly regarded speakers in the health sphere to bust the myth that medical insurance is reserved for the wealthy and only covers known illnesses. The discussions will further dwell on products that are designed based on financial capability and customized needs while transgressing on risks and sustainability of creative products such as mental health.

Description: The Part D program is funded through a variety of government subsidies and manufacturer discounts. The federal reinsurance, initially designed as protection from catastrophic spending, became a primary source of subsidies for the program. When the Inflation Reduction Act (IRA) is fully implemented in 2025, the funding of Part D will realign to its original intent.

Description: Health care continues to move from a fee-for-service model to a value-based care model. Hear from our expert panel on how actuaries can play a key role in the design and contracting of value-based agreements, monitoring experience and driving results, as well as measurement of value. The discussion will cover different structures currently in use, types of services covered (total cost of care, claim service lines, specialties, condition based, pharmacy products, etc), as well as nuances by market (Medicare FFS, MA, Commercial, Medicaid). The panel will discuss latest innovations in the value-based care space, as well as how COVID-19 has impacted these contracts. This interactive session will also allow you to ask your questions to our diverse group of panelists.

Description: The following videos are from Matt Emery, FSA, MAAA, CERA. Matt is a Vice President of Actuarial at HarmonyCares. He is an avid SOA volunteer. Matt brings a background and expertise in Value Based Care, Medicare Advantage, and Pharmacy pricing. In this video Matt Emery delves into the transformative landscape of Value Based Programs within Medicare. With a keen eye on aligning regulators, insurers, and healthcare providers, emery highlights the stark differences between the traditional Fee-For-Service model (FFS) and the evolving paradigm of Value Based Care (VBC) He emphasizes VBC’s focus on incentivizing improved patient outcomes, cost-efficiency, and equity, underlining the critical role of CMS and its strategic goals for widespread adoption. Matt navigates through key programs like MSSP and REACh, showcasing their eligibility criteria, assignment methodologies, and approaches to calculating savings or losses, while shedding light on the nuanced tracks within these models that balance risk and reward for participating ACOs. Contributors: Matt Emery, FSA, MAAA, CERA; Mitchell Momanyi FSA, MAAA; Jon Forster ASA, MAAA.